Move from type 2 to Type 1.

[Miss Piggywig]

Sorry for the silly questions. I've been type 2 for 8 years and had good control with meds and diet. Recent DKA and hospital stay, now told I'm type 1. I have Basel and bolsal insulin. I'm struggling to get sugars down. First meal out pizza hut, I've carb counted and given 8 units (ratio of 10 g to 0.5 units) but bloods not coming down. Am I being to cautious with the insulin? What would people expect to be injecting at the beginning? I've been low carb for so long it's going to take some change. Sugars running between 13-18.
Which carb counting app would people recommend? Feeling very lost.

 

[EllieM]

Hi @Miss Piggywig

As a long term T1 I have to say that many T1s find pizza a hard one to dose for so it may not have been the easiest choice for your first meal out. (The fat in the pizza can delay the absorption of the carbs and some people need to split their bolus dose to cover it). Accordingly to my maths you had 160g of carbs in your meal?

What has your doctor or DN told you about carb counting and insulin dosing? (I believe there is a DAFNE course in the UK which is highly recommended for teaching T1s how to adjust their doses, but it may take a while for you to get on it. There is also an online BERTIE course. The link below has more information.

Type 1 diabetes – Doing a type 1 diabetes course

Find out about courses for managing type 1 diabetes.

www.nhs.uk

As different people need massively different doses of insulin it can take a while to work out your carb ratios (this can also vary by time of day) and your correction ratio (amount of insulin you need to reduce your bg by 1 mmol/L). You are probably also taking a long acting basal insulin which may need adjusting? Has your DN talked about correction ratios?

Hopefully you are now getting a libre on prescription and your DN is in frequent contact to help you adjust your dosing. (A food/bg diary will help with this).

You have to gradually change insulin doses because insulin needs vary massively from person to person and you also don't know how much of your own insulin you are still producing. Some T1s might take over 100 units of insulin a day, while others only need 10. Taking too much insulin is dangerous (hopefully you have had hypos explained to you and you know to carry emergency short acting carbs around so you can treat any hypos when they happen).


Sorry for the wall of text above.

In short
1) It takes time to get your insulin dosing right as people's insulin needs vary so much
2) make sure you always have glucose or sweets with you to treat hypos
3) don't panic, you'll get there

and most important

There are no silly questions.

 

[Miss Piggywig]

Thank you for your reply. I have a free style Libra and watching it go up is scary. Tomorrow I will go back to my more normal diet and try and get these sugars down. It was my daughter's birthday and her choice so a tricky one. I guess I just need to give myself some time its only day 3!.
I've been on Basel insulin before so ok with the hypos ect. Have carried sugar for a long time now. I think I'm just frightened of giving too much insulin.

 

[ATB123]

Sorry for the silly questions. I've been type 2 for 8 years and had good control with meds and diet. Recent DKA and hospital stay, now told I'm type 1. I have Basel and bolsal insulin. I'm struggling to get sugars down. First meal out pizza hut, I've carb counted and given 8 units (ratio of 10 g to 0.5 units) but bloods not coming down. Am I being to cautious with the insulin? What would people expect to be injecting at the beginning? I've been low carb for so long it's going to take some change. Sugars running between 13-18.
Which carb counting app would people recommend? Feeling very lost.

Don't be scared. I'm the same as you, originally T2 7 years ago, but Type 1 since late last year, started off on basal only till my bloods came back, then given T1 diagnosis and bolus as well. I still haven't got my head around it, but have had some help from this forum. I have a Libre which has been a godsend and I don't think I would have been able to manage as well without it. My advice would be to take it slowly, learn about your body's response at different times of the day, I tend to need a lower ratio in the evenings than I do in the mornings. And even if you take it slowly, your overall numbers will still be an improvement on what they were and you can gradually tighten up. I'm quite settled now on 9 units basal, 2-3 units breakfast and lunch and 4-5 units in the evening. I don't snack which has helped me to establish a routine. And I have accepted that I do have spikes after food but they do come down. Just take it slowly, and ask on here if you struggle, there are loads of experienced T1s on here who will help you.